AAPC CPC Chapter 20
1. A patient who has had two 95813
recent seizures underwent a
3-hour EEG study. What CPT Rationale: In the CPT Index look for EEG
code is reported? which directs you to Electroencephalog-
raphy (EEG). Under Electroencephalogra-
phy (EEG)/Monitoring you are directed
to 95812-95813, 95950-95953 and 95956.
Code range 95812 - 95813 is based on time.
Code 95813 describes an EEG (electroen-
cephalogram), more than 1 hour. This patient
had a 3-hour study which is reported with
95813.
2. A 15 year-old underwent 92604
placement of a cochlear im-
plant 1 year ago. It now needs Rationale: Cochlear implants differ from
to be reprogrammed. What hearing aids; they bypass the damaged part
CPT code is reported for the of the ear. The use of a cochlear implant
reprogramming? involves relearning how to hear and react to
sounds. In the CPT Index look for Cochlear
Device/Programming which directs you to
codes 92602, 92604. The code selection is
based on the age of the patient and whether
it is the initial programming or subsequent
reprogramming. Code 92604 describes sub-
sequent reprogramming for a patient age 7
or older.
3. A 5 year-old fell on broken 99152, 99153
glass and required suturing
of a laceration. Due to the Rationale: Moderate sedation is often used
age and combative behavior for pediatric patients in situations not nor-
of the patient, the provider uti- mally requiring sedation. In this case, the
lized moderate sedation while provider administered sedation with a nurse
repairing the laceration. The assisting in monitoring the patient. In the
provider gave the child 50 CPT Index look for Sedation/Moderate/with
mg of Ketamine IM. A nurse Independent Observation and you are direct-
monitored the patient during ed to code range 99151-99153. Code se-
the procedure which took 30 lection is based on age of the patient and
, AAPC CPC Chapter 20
minutes. What CPT code is the length of time. Code 99152 describes
reported for moderate seda- an encounter using moderate sedation, and
tion? the physician or other qualified health care
professional rendering the diagnostic or ther-
apeutic service also manages the sedation.
This code is specific for the age of the patient
and up to 15 minutes of time. Add-on 99153
is for each additional 15 minutes of intraser-
vice time.
4. A new patient with cystic 94667
fibrosis underwent evalua-
tion of lung function, includ- Rationale: In the CPT Index look for
ing percussion, vibration and Pulmonology/Therapeutic/Manipulation of
cupping to the chest wall to Chest Wall or Chest Wall/Manipulation which
facilitate his lung function. directs you to 94667-94668. 94667 is the
What CPT code(s) is/are re- correct code since it includes the patient's
ported for this service? first time, and it includes the evaluation.
5. A patient was brought to the 92950
emergency department in car-
diac arrest. The physician im- Rationale: Medical personnel usually begin
mediately initiated CPR. What cardiopulmonary resuscitation (CPR) which
CPT code is reported for provides artificial breathing and chest com-
CPR? pressions for a person in cardiac arrest. In
the CPT Index you can look for either CPR
or Cardiopulmonary Resuscitation or Resus-
citation/Cardiopulmonary. All indexed items
direct you to code 92950.
6. A patient with hypertensive I11.9
cardiovascular disease is ad-
mitted by his primary care Rationale: In the ICD-10-CM Alphabetic In-
provider. What is/are the cor- dex look for Hypertension, hypertensive/car-
rect ICD-10-CM code(s) for diovascular/disease (arteriosclerotic) (scle-
this encounter? rotic) which states to see Hypertension,
heart. Look for Hypertension/heart (disease)
(conditions in I51.4-I51.9 due to hyperten-
sion) directing you to I11.9. ICD-10-CM
1. A patient who has had two 95813
recent seizures underwent a
3-hour EEG study. What CPT Rationale: In the CPT Index look for EEG
code is reported? which directs you to Electroencephalog-
raphy (EEG). Under Electroencephalogra-
phy (EEG)/Monitoring you are directed
to 95812-95813, 95950-95953 and 95956.
Code range 95812 - 95813 is based on time.
Code 95813 describes an EEG (electroen-
cephalogram), more than 1 hour. This patient
had a 3-hour study which is reported with
95813.
2. A 15 year-old underwent 92604
placement of a cochlear im-
plant 1 year ago. It now needs Rationale: Cochlear implants differ from
to be reprogrammed. What hearing aids; they bypass the damaged part
CPT code is reported for the of the ear. The use of a cochlear implant
reprogramming? involves relearning how to hear and react to
sounds. In the CPT Index look for Cochlear
Device/Programming which directs you to
codes 92602, 92604. The code selection is
based on the age of the patient and whether
it is the initial programming or subsequent
reprogramming. Code 92604 describes sub-
sequent reprogramming for a patient age 7
or older.
3. A 5 year-old fell on broken 99152, 99153
glass and required suturing
of a laceration. Due to the Rationale: Moderate sedation is often used
age and combative behavior for pediatric patients in situations not nor-
of the patient, the provider uti- mally requiring sedation. In this case, the
lized moderate sedation while provider administered sedation with a nurse
repairing the laceration. The assisting in monitoring the patient. In the
provider gave the child 50 CPT Index look for Sedation/Moderate/with
mg of Ketamine IM. A nurse Independent Observation and you are direct-
monitored the patient during ed to code range 99151-99153. Code se-
the procedure which took 30 lection is based on age of the patient and
, AAPC CPC Chapter 20
minutes. What CPT code is the length of time. Code 99152 describes
reported for moderate seda- an encounter using moderate sedation, and
tion? the physician or other qualified health care
professional rendering the diagnostic or ther-
apeutic service also manages the sedation.
This code is specific for the age of the patient
and up to 15 minutes of time. Add-on 99153
is for each additional 15 minutes of intraser-
vice time.
4. A new patient with cystic 94667
fibrosis underwent evalua-
tion of lung function, includ- Rationale: In the CPT Index look for
ing percussion, vibration and Pulmonology/Therapeutic/Manipulation of
cupping to the chest wall to Chest Wall or Chest Wall/Manipulation which
facilitate his lung function. directs you to 94667-94668. 94667 is the
What CPT code(s) is/are re- correct code since it includes the patient's
ported for this service? first time, and it includes the evaluation.
5. A patient was brought to the 92950
emergency department in car-
diac arrest. The physician im- Rationale: Medical personnel usually begin
mediately initiated CPR. What cardiopulmonary resuscitation (CPR) which
CPT code is reported for provides artificial breathing and chest com-
CPR? pressions for a person in cardiac arrest. In
the CPT Index you can look for either CPR
or Cardiopulmonary Resuscitation or Resus-
citation/Cardiopulmonary. All indexed items
direct you to code 92950.
6. A patient with hypertensive I11.9
cardiovascular disease is ad-
mitted by his primary care Rationale: In the ICD-10-CM Alphabetic In-
provider. What is/are the cor- dex look for Hypertension, hypertensive/car-
rect ICD-10-CM code(s) for diovascular/disease (arteriosclerotic) (scle-
this encounter? rotic) which states to see Hypertension,
heart. Look for Hypertension/heart (disease)
(conditions in I51.4-I51.9 due to hyperten-
sion) directing you to I11.9. ICD-10-CM
